The Berejiklian government plays the blame game as Sydney’s Delta outbreak spreads to regional areas with under-resourced healthcare facilities.

According to the NSW government, the Delta variant emerged on 16 June, when an air-crew driver working under lax NSW Public Health Orders that did not require him to wear a mask or be vaccinated, was diagnosed.

By then, the driver had visited a dozen sites in Sydney’s eastern suburbs. Gladys Berejiklian waited until 25 June before imposing a light lockdown on parts of the city’s east. The virus seeded into Western Sydney.

Loose regulations allowed movement between Sydney and the rest of NSW: for work, to look at real estate, to get COVID-19-tested, or to visit a second residence, for example. Delta subsequently spread across the state.

Rural communities with limited and under-resourced healthcare facilities have been grappling with the consequences.

Healthcare services for people outside of Sydney were dire even before COVID-19. This was made clear in a December 2020 sub-mission from the NSWNMA to a state parliamentary inquiry into health care in rural, regional and remote NSW.

The NSWNMA submission said: “It is not acceptable that residents in the rest of NSW are provided with an inadequately resourced, substandard system of healthcare while metropolitan Sydney residents enjoy far superior access and outcomes.”

It made 24 specific recommendations for improvements, including boosting nursing numbers at sites with no doctor to ensure a minimum of three per shift – two of whom would be RNs. It also recommended better staffing of emergency departments and recruiting more nurse practitioners.

Remote indigenous communities with higher rates of chronic illnesses such as diabetes or kidney disease and shamefully low vaccination rates – a shared federal and NSW responsibility – are particularly vulnerable to COVID-19.

“Indigenous Australians were one of our greatest concerns at the start of this pandemic,” Prime Minister Scott Morrison said in December.

Morrison’s actions failed to match his rhetoric.

Despite Aboriginal people over 12 being prioritised as 1B in the rollout, only 6.3 per cent of the Aboriginal population in Western NSW was fully vaccinated by 26 August, compared to 26 per cent of the non-Indigenous population in the region, ABC News reported.

Aboriginal communities dangerously exposed

Human Rights Watch accused both the federal and NSW governments of leaving Aboriginal people “dangerously exposed to COVID-19 with limited access to vaccines”.

The Maari Ma Aboriginal health service in the Far West warned both the NSW and federal governments in March 2020 that they needed to urgently prepare for an outbreak.

However, the Berejiklian government refused to take any responsibility.

Health Minister Brad Hazzard agreed the vaccination rollout to Aboriginal communities had been “challenging”, but said it was a federal government responsibility.

As The Guardian’s Anne Davies wrote: “The NSW Government’s response (to the worsening Delta crisis) has been a blame game … When it comes to the state’s role there is a stubborn reluctance to admit there may be a better way.”

On Aboriginal health, the NSWNMA submission says Aboriginal people in regional, rural and remote parts of NSW should have access to Aboriginal Community Controlled Health Services.

Epidemiologist Dr Peter Malouf, from the Aboriginal Health and Medical Research Council of NSW, told a parliamentary inquiry into the pandemic that the state government was “very lacking in engagement, particularly listening to the voices of Aboriginal people”.  

The remote settlement of Enngonia in north-west NSW has no hospital, no resident nurse, and no shop. Its mostly Aboriginal residents must travel 97 kilometres to Bourke for health care and groceries.

By the third week of September, COVID-19 had infected 25 – or about one third – of the township’s indigenous population, said Tannia Edwards, CEO of the Murrawarri Local Aboriginal Land Council in Enngonia.

The virus had also claimed the life of a beloved elder.

Ms Edwards told The Lamp that vaccinations were not provided at Enngonia until shortly before the township’s first infection, which followed positive cases in Bourke and Dubbo.

She said vaccination should have started once the virus reached Dubbo, almost 500 kilometres away, because Enngonia residents often travelled there on public transport.

She said government health messaging on COVID-19 had been poor.

“It’s not people’s fault they weren’t getting vaccinated. We needed better messaging, because not everyone can understand what’s happening on TV.”

She said it was hard to self-isolate when as many as 12 people could be living in a four-bedroom home.

“It’s not possible to tell small children they’ve got to stay in a room for 14 days. It’s not possible, and it’s cruel.”

She said rural fire service volunteers were doing a great job, delivering food parcels to the community.

Health service manager for the Bourke Aboriginal Health Service, Claire Williams, told The Guardian the public health response to Delta was “chaotic” and said it wasn’t clear who was in charge.

The Aboriginal Health Service is running a vaccination clinic in Enngonia and delivering medicines.

Western NSW Local Health District said it was doing “routine COVID-19 testing” in Enngonia and had begun “a household-by-household assessment of the community’s health and social needs”.

It said COVID-19 vaccination of indigenous Australians was a federal responsibility.